Colonial Healthcare

Current State: None change

General
Medicaid Data
Medicare Cost Report
Staff
Quality Measures
Health Survey
Fire Safety Survey
Definitions

Overall Facility Star Rating:
Address:: 12225 Shale Ridge Lane
Auburn, CA 95602, Placer County
Phone:: (916)885-7511
Medicare Cost Reports Available from:: 1996-07-01 To 2011-06-06
Health Survey Star Rating:
Health Survey:: 42 Deficiencies Listed | 2011-04-15
Fire Survey:: 35 Deficiencies Listed | 2011-04-20 | Sprinkler Status: fully sprinklered

Item Name:	Item Value:
Medicare	No
Medi-Cal SNF	No
Medi-Cal ICF	--
Medi-Cal MD	--
Medi-Cal DD	--
Short Doyle	--
VA	--
Champus	--
Other	No

Item Name:	Item Value:
Medicare	3,819
Medi-Cal	44,757
Self Pay	1,399
Managed Care	775
Other Payors	1,582

Item Name:	Item Value:
Licensed Beds	205
Monthly Avg. Lic. Beds	205
Avail. Beds	205
Monthly Avg. Avail. Beds	205
Admissions	482
Discharges	502

Item Name:	Item Value:
Subacute Care	--
Subacute Pediatric	--
Trans. Inpat. Care - Medi-Cal	--
Trans. Inpat. Care - Rehab	--
Total Trans. Inpat. Care	--

Item Name:	Item Value:
Preferred Stock	0
Common Stock	10,000
Additional Paid in Capital	8,227,800
Retained Earnings	8,227,800
Treasury Stock	0
Divisional Equity	0

Item Name:	Item Value:
Beginning Balance	-1,475,842
Net Income	-6,696,559
Capital Contrib.	0
Proceeds from Sale of Stock	0
Owners Draw	0
Dividends Declared	0
Donated Prop. Plant & Equipment	0
Acquisitions of Pooled Companies	0
Stock Options Exercised	0
Related Party Transfers	0
Unrealized Losses on Marketable Equity Sec.	0
Other Additions	96,868
Total Additions	-6,599,691
Prop. & Equip. Additions	0
Principal Payments on Long Term Debt	0
Other Transfers	0
Total Transfers	0
End of Year Balance	-8,075,533

Item Name:	Item Value:
General Fund	0
Divisional Fund	0

Item Name:	Item Value:
Goodwill	0
Unamortized Loan Costs	0
Org. Costs	0
Other	0
Total	0

Item Name:	Item Value:
Notes & Loans Payable	0
Accounts Payable	352,430
Accrued Comp. & Related	395,868
Other Accrued	0
Advances from 3rd Parties	0
Payable to 3rd party Payors for Contract Settlemen	0
Due to Restricted Funds	0
Income Taxes Payable	0
Payables to Related Parties	4,748,373
Current Long Term Debt Maturities	0
Other	5,339,845
Total	10,836,516

Item Name:	Item Value:
Income Taxes	0
3rd Party Income	0
Other	0
Total	0

Item Name:	Item Value:
Mortgages Payable	0
Construction Loans	0
Notes Under Revolving Credit	0
Capitalized Lease Obligations	0
Bonds Payable	0
Payable to Related Parties	0
Other	0
Total	0

Item Name:	Item Value:
Cash	-1,133,080
Marketable Securities	0
Limited Use	0
Acc. & Notes Receiv.	672,626
Est. Allow. for Uncollectibles	-109,423
3rd Party Contract Settl. Receiv.	0
Pledges & Other Receiv.	0
Due from Restricted Funds	0
Inventories	15,700
Receiv. from Related Parties	0
Prepaid Expenses & Other	89,505
Total	-464,672

Item Name:	Item Value:
Cash	0
Marketable Securities	0
Other	0
Total	0

Item Name:	Item Value:
Land	0
Land Improvements	0
Buildings and Improvements	284,502
Acc. Deprec. Bldgs & Land Improv.	-132,798
Leasehold Improv.	1,240,236
Acc. Deprec. Leasehold Improv.	-672,798
Equipment	966,445
Acc. Deprec. Equipment	-616,213
Construction in Progress	0

Item Name:	Item Value:
Property Plant Equipment	1,026,778
Acc. Deprec. Prop. Plant Equipment	0
Other Invest. at Cost	0
Receiv. from Related Parties Noncurrent	1,129,503
Deposits & Other	0
Total	2,156,281

Account Title	Related Party	Service or Supply	Amount
Administration	Horizon West Headquarters	Management Fees	586,290
Leases And Rentals	Auburn Manor Holding	Lease Building	430,500
Various Lines, Pg 10.1 Col 2	Care West & South Placer Ins.	Worker Comp & Brokerage Fees	162,843
Various Lines, Pg 10.1 Col 3	Pacific West Pharmacy	Pharmacy	368,190

Account Title	Related Party	Amount
Receivable From Related Partie	Various	1,129,503
Payable To Related Parties	Various	4,748,373

Item Name:	Item Value:
Pharmacy	0
Patient Supplies	0
Laboratory	0
Radiology	0
Physical Therapy	0
Speech Therapy	0
Occupational Therapy	0
Audiology	0
Prosthetic Devices	0
Social Services	0
Physician Care	0
Dental Care	0
Podiatric Care	0
Chiropractic Care	0
Optometric Care	0
Psychiatric Care	0
Recreation and Activity	0
Alcoholism and Substance Abuse Treatment	0
Home Health	0
Hospice	0
Long Term Rehabilitation	0
Patient Education	0
Adult Day Health Care	0
Other	0

Item Name:	Item Value:
Plant Oper. & Maint.	110,287
Patient Supplies	0
Specialized Support Surfaces	0
Physical Therapy	0
Respiratory Therapy	0
Occupational Therapy	0
Speech Pathology	0
Pharmacy	0
Laboratory	0
Home Health Services	0
Other Ancillary Services	0
Skilled Nursing Care	4,164,182
Intermediate Care	0
Mentally Disordered Care	0
Develop. Disabled Care	0
Subacute Care	0
Subacute Care Pediatric	0
Transitional Inpatient Care	0
Hospice Inpatient Care	0
Other Routine Services	0
Social Services	107,996
Activities	124,597
Administration	431,386
Inservice Education Nursing	67,229

Item Name:	Item Value:
Plant Oper. & Maint.	34,899
Patient Supplies	0
Specialized Support Surfaces	0
Physical Therapy	0
Respiratory Therapy	0
Occupational Therapy	0
Speech Pathology	0
Pharmacy	0
Laboratory	0
Home Health Services	0
Other Ancillary Services	0
Skilled Nursing Care	1,317,727
Intermediate Care	0
Mentally Disordered Care	0
Develop. Disabled Care	0
Subacute Care	0
Subacute Care Pediatric	0
Transitional Inpatient Care	0
Hospice Inpatient Care	0
Other Routine Services	0
Social Services	34,175
Activities	39,428
Administration	136,510
Inservice Education Nursing	21,274

Item Name:	Item Value:
Plant Oper. & Maint.	369,218
Patient Supplies	108,255
Specialized Support Surfaces	36,319
Physical Therapy	290,749
Respiratory Therapy	0
Occupational Therapy	182,893
Speech Pathology	75,666
Pharmacy	270,727
Laboratory	24,927
Home Health Services	0
Other Ancillary Services	32,821
Skilled Nursing Care	256,498
Intermediate Care	0
Mentally Disordered Care	0
Develop. Disabled Care	0
Subacute Care	0
Subacute Care Pediatric	0
Transitional Inpatient Care	0
Hospice Inpatient Care	0
Other Routine Services	0
Social Services	12,374
Activities	29,407
Administration	8,783,828
Inservice Education Nursing	250

Item Name:	Item Value:
Plant Oper. & Maint.	514,404
Patient Supplies	108,255
Specialized Support Surfaces	36,319
Physical Therapy	290,749
Respiratory Therapy	0
Occupational Therapy	182,893
Speech Pathology	75,666
Pharmacy	270,727
Laboratory	24,927
Home Health Services	0
Other Ancillary Services	32,821
Skilled Nursing Care	5,738,407
Intermediate Care	0
Mentally Disordered Care	0
Develop. Disabled Care	0
Subacute Care	0
Subacute Care Pediatric	0
Transitional Inpatient Care	0
Hospice Inpatient Care	0
Other Routine Services	0
Social Services	154,545
Activities	193,432
Administration	9,351,724
Inservice Education Nursing	88,753

Item Name:	Item Value:
Bldgs & Improv. Deprec.	18,864
Leasehold Improv. Deprec.	83,002
Equip. Deprec.	50,684
Deprec. & Amort. - Other	0
Leases & Rentals	35,875
Property Taxes	93,343
Property Insurance	8,500
Prop. Plant & Equip. Interest	56,012
Other Interest	0
Workers Comp	162,843
State Unemp. Ins.	59,863

Item Name:	Item Value:
Salaries & Wages	441,834
Employee Benefits	139,815
Other Expenses	412,341
Total	993,990
Productive Hours	36,071
Hourly Average Pay	12.3
Raw Food	286,132

Item Name:	Item Value:
Salaries & Wages	93,271
Employee Benefits	29,515
Other Expenses	30,742
Total	153,528
Productive Hours	8,672
Hourly Average Pay	10.8

Item Name:	Item Value:
Salaries and Wages	221,796
Employee Benefits	70,186
Other Expenses	57,192
Total	349,174
Productive Hours	20,903
Hourly Average Pay	10.6

Name
Ellen Keykendall
Shyrel Harmon Gaskey
Vicky Harmon Meaglia
Cynthia Harmon Sayre
Susan Harmon Smeja
Pamela Harmon Fixin
Christopher Harmon

Name	Occupation	Compensation
Milton Harmon	President	0
Vicky Harmon Meaglia	Vice President	0
Shyrel Harmon Gaskey	Secretary/Treasurer	0

Name	Address	Percent Ownership
22 Related Facilities	Various Locations In Calif
4 Related Facilities	Various Locations In Utah

Name	Title	Avg Hours Wkly	Current Period Compensation	Prior Period Compensation
Ronald A. Reyes		40	106,355	92,704

Item Name:	Item Value:
Name	0
Address	0
City	0
State	0
Zip	0
Phone	0

Item Name:	Item Value:
Skilled Nursing Care	11,010,217
Intermediate Care	0
Mentally Disordered Care	0
Develop. Disabled Care	0
Subacute Care	0
Subacute Care - Pediatric	0
Transitional Inpatient Care	0
Hospice Inpatient Care	0
Other	0
Total	11,010,217

Item Name:	Item Value:
Patient Supplies	221,854
Spec. Support Surfaces	0
Physical Therapy	737,316
Respiratory Therapy	0
Occupational Therapy	498,420
Speech Pathology	160,620
Pharmacy	727,368
Laboratory	57,769
Home Health Services	0
Other	0
Total	2,576,763

Item Name:	Item Value:
Charity	0
Administrative	0
Contractual Medicare	256,129
Contractual Medi-Cal	918,393
Contractual Managed Care	187,955
Contractual Other	19,818
Other	0
Total	1,382,295

Item Name:	Item Value:
Vending Machine	0
Laundry and Linen	0
Social Services Fees	0
Donated Supplies	0
Telephone	0
Transfers from Restricted Funds	0
Nonpatient Food	30
TV & Radio	2,078
Parking	0
Rebates & Refunds on Expenses	24,060
Nonpatient Room Rentals	0
Nonpatient Drug Sales	0
Nonpatient Supplies Sales	0
Medical Records & Abstract Sales	0
Cash Discounts on Purchases	0
Sales of Scrap & Waste	0
Other	9,385
Total	35,553

Item Name:	Item Value:
Name	Horizon West Healthcare, Inc.
Address	4020 Sierra Colege Blvd, #190
City	Rocklin
State	CA
Zip	95677

Item Name:	Item Value:
Legal Name	Colonial Healthcare, Inc.
End Date	12/31/10
Begin Date	1/1/10
State License No	30000049
Medical Prov No	ZZR05776G
DBA	Horizon West Auburn Ridge
Administrator	Ronald A. Reyes
Previous Name	0
Previous State License No	0
Previous Medical Prov Number	0
License Category	Skilled nursing facility
Control Type	Investor owned
Legal Org.	Division of corporation

Item Name:	Item Value:
Total Patient Days	52,332
Occupancy	69.9

Item Name:	Item Value:
Name	Axiom Healthcare Group
Phone	(818) 456-0940
Address	23480 Park Sorrento #100 B
City	Calabasas
Zip	91302-0000
State	CA

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Other Cost Report Years:

Fiscal Year Begin: 2011-01-01 | Fiscal Year End: 2011-06-06

Worksheet	Description
Worksheet S, Part 1 & 2	Certification and Settlement Summary
Worksheet S-2	Complex Identification Data
Worksheet S-3	Statistical Data
Worksheet S-3, Part 2 & 3	SNF Wage Index Information
Worksheet S-7, Part 4	Prospective Payment for SNF Statistical Data (RUGs)
Worksheet A	Reclassification and Adjustment of Trial Balance of Expenses
Worksheet A-7	Analysis of Changes During Cost Reporting Period in Capital Asset Balances
Worksheet A-8	Adjustments to Expenses
Worksheet A-8-1	Statement of Costs of Services from Related Organizations
Worksheet B, Part 1	Cost Allocation - General Service Costs
Worksheet B, Part 2	Allocation of Capital - Related Costs
Worksheet B-1, Part 1	Cost Allocation - General Service Costs
Worksheet C	Ratio of Cost to Charges for Ancillary and Outpatient Cost Centers
Worksheet D, Part 1 (Title XVIII) SNF Facility Type	Apportionment of Ancillary and Outpatient Cost and Reduction of Therapy Costs
Worksheet D, Part 2 & 3 (Title XVIII) SNF Facility Type	Apportionment of Ancillary and Outpatient Cost and Reduction of Therapy Costs for Title XVIII (SNF)
Worksheet D-1, Part 1 & 2 (Title XVIII) SNF Facility Type	Computation of Inpatient Routine Costs
Worksheet E, Part 3 (Title XVIII) SNF Facility Type	Calculation of Reimbursement Settlement (SNF, Title XVIII)
Worksheet E-1 (Title XVIII) SNF Facility Type	Analysis of Payments to Providers for Services Rendered (SNF, Title XVIII)
Worksheet G	Balance Sheet
Worksheet G-2, Part 1 & 2	Statement of Patient Revenues and Operating Expenses
Worksheet G-3	Statement of Revenues and Expenses

	National Average	California Average	Colonial Healthcare
Nurse Staffing Star Rating
Total Number of Residents	88.45	83.75	122.0
Total Number of Licensed Nurse Staff Hours per Resident per Day	1 hour and 35 minutes	1 hour and 42 minutes	1 hour and 21 minutes
RN Hours per Resident per Day	45 minutes	49 minutes	45 minutes
RN Staff Only Star Rating
LPN/LVN Hours per Resident per Day	50 minutes	56 minutes	36 minutes
CNA Hours per Resident per Day	2 hours and 28 minutes	2 hours and 41 minutes	3 hours and 8 minutes

Quality Measures	National Average	California Average	Colonial Healthcare
Quality Measures Star Rating
Long-Stay Residents
NOTE: For the following Measures, Higher Percentages are better.
Percent of long-stay residents given influenza vaccination during the flu season	86.36%	86.36%	92%
Percent of long-stay residents who were assessed and given pneumococcal vaccination	85.25%	85.25%	96%
NOTE: for the following measures, lower percentages are better.
Percent of long-stay residents whose need for help with daily activities has increased	13.31%	13.31%	14%
Percent of long-stay residents who have moderate to severe pain	3.06%	3.06%	9%
Percent of high-risk long-stay residents who have pressure sores	9.73%	9.73%	7%
Percent of low-risk long-stay residents who have pressure sores	1.51%	1.51%	3%
Percent of long-stay residents who were physically restrained	2.59%	2.59%	10%
Percent of long-stay residents who are more depressed or anxious	13.63%	13.63%	8%
Percent of low-risk long-stay residents who lose control of their bowels or bladder	47.49%	47.49%	51%
Percent of long-stay residents who have/had a catheter inserted and left in their bladder	4.76%	4.76%	6%
Percent of long-stay residents who spend most of their time in bed or in a chair	3.81%	3.81%	2%
Percent of long-stay residents whose ability to move about in and around their room got worse	10.22%	10.22%	12%
Percent of long-stay residents who had a urinary tract infection	8.43%	8.43%	10%
Percent of long-stay residents who lose too much weight	7.20%	7.20%	9%
Short-Stay Residents
NOTE: For the following Measures, Higher Percentages are better.
Percent of short-stay residents given influenza vaccination during the flu season	77.85%	77.85%	89%
Percent of short-stay residents who were assessed and given pneumococcal vaccination	76.94%	76.94%	94%
NOTE: For the following Measures, Lower Percentages are better.
Percent of short-stay residents who have delirium	1.31%	1.31%	1%
Percent of short-stay residents who had moderate to severe pain	17.17%	17.17%	32%
Percent of short-stay residents who have pressure sores	10.78%	10.78%	8%

Nutrition and Dietary Deficiencies

Inspectors determined that the nursing home failed to:	Inspection Date	Correction Date	Level of Harm	Scope
1. Hire a qualified dietician.	2008-11-21	2008-12-23	Minimal harm or potential for actual harm	Widespread
2. Hire enough skilled workers to carry out dietary service.	2008-11-21	2008-12-23	Minimal harm or potential for actual harm	Isolated
3. Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature.	2008-11-21	2008-12-23	Minimal harm or potential for actual harm	Pattern
4. Store, cook, and give out food in a safe and clean way.	2008-11-21	2008-12-23	Minimal harm or potential for actual harm	Widespread
5. Offer other nutritional food to each resident who will not eat the food served.	2011-04-15	2011-06-15	Minimal harm or potential for actual harm	Pattern
6. Hire enough skilled workers to carry out dietary service.	2011-04-15	2011-06-15	Minimal harm or potential for actual harm	Pattern
7. Store, cook, and give out food in a safe and clean way.	2011-04-15	2011-06-15	Minimal harm or potential for actual harm	Pattern
8. Store, cook, and give out food in a safe and clean way.	2010-02-26	2010-03-25	Minimal harm or potential for actual harm	Pattern

Pharmacy Service Deficiencies

Inspectors determined that the nursing home failed to:	Inspection Date	Correction Date	Level of Harm	Scope
1. At least once a month, have a licensed pharmacist check the drugs that each resident takes.	2008-11-21	2008-12-23	Minimal harm or potential for actual harm	Isolated
2. Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%.	2008-11-21	2008-12-23	Minimal harm or potential for actual harm	Isolated
3. Properly mark drugs and other similar products.	2008-11-21	2008-12-23	Minimal harm or potential for actual harm	Isolated
4. Have drugs and other similar products available, which are needed every day and in emergencies, and give them out properly.	2011-04-15	2011-06-15	Minimal harm or potential for actual harm	Isolated
5. 1) make sure that residents who take drugs are not given too many doses or for too long; 2) make sure that the use of drugs is carefully watched; or 3) stop or change drugs that cause unwanted effects.	2010-02-26	2010-03-25	Minimal harm or potential for actual harm	Isolated
6. Properly mark drugs and other similar products.	2010-02-26	2010-03-25	Minimal harm or potential for actual harm	Isolated

Environmental Deficiencies

Inspectors determined that the nursing home failed to:	Inspection Date	Correction Date	Level of Harm	Scope
1. Put firmly secured handrails on each side of hallways.	2008-11-21	2008-12-23	Minimal harm or potential for actual harm	Isolated
2. Keep safe, clean and homelike surroundings.	2008-11-21	2008-12-23	Minimal harm or potential for actual harm	Isolated
3. Provide needed housekeeping and maintenance.	2008-11-21	2008-12-23	Minimal harm or potential for actual harm	Isolated
4. Make sure that the nursing home area is free of dangers that cause accidents.	2008-11-21	2008-12-23	Minimal harm or potential for actual harm	Isolated
5. Provide needed housekeeping and maintenance.	2011-04-15	2011-06-15	Minimal harm or potential for actual harm	Pattern
6. Have a program to keep infection from spreading.	2011-04-15	2011-06-15	Minimal harm or potential for actual harm	Pattern
7. Make sure that the nursing home area is free of dangers that cause accidents.	2011-04-15	2011-06-15	Minimal harm or potential for actual harm	Pattern
8. Make sure that the nursing home area is safe, easy to use, clean and comfortable.	2010-02-26	2010-03-25	Minimal harm or potential for actual harm	Pattern
9. Keep safe, clean and homelike surroundings.	2010-02-26	2010-03-25	Minimal harm or potential for actual harm	Pattern
10. Provide needed housekeeping and maintenance.	2010-02-26	2010-03-25	Potential for minimal harm	Pattern
11. Have a program to keep infection from spreading.	2010-02-26	2010-03-25	Minimal harm or potential for actual harm	Pattern
12. Make sure that the nursing home area is free of dangers that cause accidents.	2010-02-26	2010-03-25	Minimal harm or potential for actual harm	Pattern

Administration Deficiencies

Inspectors determined that the nursing home failed to:	Inspection Date	Correction Date	Level of Harm	Scope
1. Have a detailed, written plan for disasters and emergencies.	2008-11-21	2008-12-23	Minimal harm or potential for actual harm	Isolated
2. Keep accurate and appropriate medical records.	2008-11-21	2008-12-23	Minimal harm or potential for actual harm	Isolated
3. Keep accurate and appropriate medical records.	2011-04-15	2011-06-15	Minimal harm or potential for actual harm	Isolated
4. Keep clinical information safe, so that it will not be lost, destroyed or used by the wrong person.	2011-04-15	2011-06-15	Minimal harm or potential for actual harm	Isolated

Resident Rights Deficiencies

Inspectors determined that the nursing home failed to:	Inspection Date	Correction Date	Level of Harm	Scope
1. Tell each resident who can get medicaid benefits about 1) which items and services medicaid covers and which the resident must pay for; or 2) how to apply for medicaid, along with the names and addresses of state groups that can help.	2011-04-15	2011-06-15	Minimal harm or potential for actual harm	Pattern
2. Allow residents to easily see the results of the nursing home's most recent survey.	2011-04-15	2011-06-15	Minimal harm or potential for actual harm	Pattern
3. Provide services to meet the needs and preferences of each resident.	2011-04-15	2011-06-15	Minimal harm or potential for actual harm	Pattern
4. Listen to the resident or family groups or act on their complaints or suggestions.	2010-02-26	2010-03-25	Potential for minimal harm	Pattern

Quality Care Deficiencies

Inspectors determined that the nursing home failed to:	Inspection Date	Correction Date	Level of Harm	Scope
1. Give professional services that meet a professional standard of quality.	2008-11-21	2008-12-23	Minimal harm or potential for actual harm	Pattern
2. Give professional services that meet a professional standard of quality.	2011-04-15	2011-06-15	Potential for minimal harm	Pattern
3. Give professional services that meet a professional standard of quality.	2010-02-26	2010-03-25	Potential for minimal harm	Pattern
4. Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses.	2010-02-26	2010-03-25	Minimal harm or potential for actual harm	Pattern
5. Give each resident care and services to get or keep the highest quality of life possible.	2010-02-26	2010-03-25	Minimal harm or potential for actual harm	Isolated
6. Have enough nurses to care for every resident in a way that maximizes the resident's well being.	2010-02-26	2010-03-25	Minimal harm or potential for actual harm	Isolated

Resident Assessment Deficiencies

Inspectors determined that the nursing home failed to:	Inspection Date	Correction Date	Level of Harm	Scope
1. Screen residents when they are first admitted to send them to an area with special care for people with developmental disabilities or mental illness, if needed.	2011-04-15	2011-06-15	Minimal harm or potential for actual harm	Pattern
2. Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	2011-04-15	2011-06-15	Potential for minimal harm	Pattern

Corridor Walls and Doors Deficiencies

Inspectors determined that the building did not have:	Inspection Date	Correction Date	Level of Harm	Scope
1. Corridor and hallway doors that block smoke.	2008-12-02	2008-12-22	Minimal harm or potential for actual harm	Pattern
2. Corridor and hallway doors that block smoke.	2009-07-02	2009-07-30	Minimal harm or potential for actual harm	Isolated
3. Corridor and hallway doors that block smoke.	2011-04-20	2011-05-05	Minimal harm or potential for actual harm	Pattern
4. Corridor and hallway doors that block smoke.	2010-02-25	2010-03-29	Minimal harm or potential for actual harm	Isolated
5. Corridors that are separated from common areas by walls constructed to limit the passage of smoke.	2010-02-25	2010-03-29	Minimal harm or potential for actual harm	Isolated

Smoke Compartmentation and Control Deficiencies

Inspectors determined that the building did not have:	Inspection Date	Correction Date	Level of Harm	Scope
1. Smoke barrier doors that can resist smoke for at least 20 minutes.	2009-07-02	2009-07-30	Minimal harm or potential for actual harm	Isolated
2. Smoke barrier doors that can resist smoke for at least 20 minutes.	2011-04-20	2011-05-05	Minimal harm or potential for actual harm	Isolated
3. Walls or barriers that prevent smoke from passing through and would resist fire for at least one hour.	2011-04-20	2011-05-05	Minimal harm or potential for actual harm	Widespread
4. Walls or barriers that prevent smoke from passing through and would resist fire for at least one hour.	2010-02-25	2010-03-29	Minimal harm or potential for actual harm	Pattern
5. Smoke barrier doors that can resist smoke for at least 20 minutes.	2010-02-25	2010-03-29	Minimal harm or potential for actual harm	Isolated

Electrical Deficiencies

Inspectors determined that the building did not have:	Inspection Date	Correction Date	Level of Harm	Scope
1. Properly installed electrical wiring and equipment.	2011-04-20	2011-05-05	Minimal harm or potential for actual harm	Pattern
2. Properly installed electrical wiring and equipment.	2010-02-25	2010-03-29	Minimal harm or potential for actual harm	Widespread

Furnishings and Decorations Deficiencies

Inspectors determined that the building did not have:	Inspection Date	Correction Date	Level of Harm	Scope
1. Restrictions on the use of flammable curtains.	2011-04-20	2011-05-05	Minimal harm or potential for actual harm	Isolated
2. Restrictions on the use of highly flammable materials.	2010-02-25	2010-03-29	Minimal harm or potential for actual harm	Isolated

Illumination and Emergency Power Deficiencies

Inspectors determined that the building did not have:	Inspection Date	Correction Date	Level of Harm	Scope
1. Properly located and lighted "exit"" signs."	2008-12-02	2008-12-22	Minimal harm or potential for actual harm	Isolated
2. Properly located and lighted "exit"" signs."	2011-04-20	2011-05-05	Minimal harm or potential for actual harm	Pattern

Fire Alarm Systems Deficiencies

Inspectors determined that the building did not have:	Inspection Date	Correction Date	Level of Harm	Scope
1. Properly maintained smoke detectors.	2011-04-20	2011-05-05	Minimal harm or potential for actual harm	Isolated
2. Properly maintained smoke detectors.	2010-02-25	2010-03-29	Minimal harm or potential for actual harm	Widespread

Smoking Regulations Deficiencies

Inspectors determined that the building did not have:	Inspection Date	Correction Date	Level of Harm	Scope
1. Posted "no-smoking"" signs in areas where smoking is not permitted or did not provide ashtrays where smoking was allowed."	2011-04-20	2011-05-05	Minimal harm or potential for actual harm	Isolated
2. Posted "no-smoking"" signs in areas where smoking is not permitted or did not provide ashtrays where smoking was allowed."	2010-02-25	2010-03-29	Minimal harm or potential for actual harm	Widespread

Vertical Openings Deficiencies

Inspectors determined that the building did not have:	Inspection Date	Correction Date	Level of Harm	Scope
1. Exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detectors.	2008-12-02	2008-12-22	Minimal harm or potential for actual harm	Isolated
2. Exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detectors.	2011-04-20	2011-05-05	Minimal harm or potential for actual harm	Isolated

Medical Gases and Anesthetizing Areas Deficiencies

Inspectors determined that the building did not have:	Inspection Date	Correction Date	Level of Harm	Scope
1. Proper medical gas storage and administration areas.	2011-04-20	2011-05-05	Minimal harm or potential for actual harm	Isolated
2. Proper medical gas storage and administration areas.	2010-02-25	2010-03-29	Minimal harm or potential for actual harm	Isolated

Building Construction Deficiencies

Inspectors determined that the building did not have:	Inspection Date	Correction Date	Level of Harm	Scope
1. Approved construction type or materials.	2008-12-02	2008-12-22	Minimal harm or potential for actual harm	Isolated
2. Approved construction type or materials.	2011-04-20	2011-05-05	Minimal harm or potential for actual harm	Pattern
3. Approved construction type or materials.	2010-02-25	2010-03-29	Minimal harm or potential for actual harm	Pattern

Hazardous Area Deficiencies

Inspectors determined that the building did not have:	Inspection Date	Correction Date	Level of Harm	Scope
1. Construction that can resist fire for one hour or an approved fire extinguishing system.	2008-12-02	2008-12-22	Minimal harm or potential for actual harm	Pattern
2. Construction that can resist fire for one hour or an approved fire extinguishing system.	2011-04-20	2011-05-05	Minimal harm or potential for actual harm	Isolated
3. Properly installed hallway dispensers for alcohol-based hand rub.	2010-02-25	2010-03-29	Minimal harm or potential for actual harm	Isolated
4. Construction that can resist fire for one hour or an approved fire extinguishing system.	2010-02-25	2010-03-29	Minimal harm or potential for actual harm	Isolated

Automatic Sprinkler Systems Deficiencies

Inspectors determined that the building did not have:	Inspection Date	Correction Date	Level of Harm	Scope
1. Automatic sprinkler systems that have been maintained in working order.	2008-12-02	2008-12-22	Minimal harm or potential for actual harm	Pattern
2. Portable fire extinguishers.	2008-12-02	2008-12-22	Potential for minimal harm	Pattern
3. Automatic sprinkler systems that have been maintained in working order.	2011-04-20	2011-05-05	Minimal harm or potential for actual harm	Pattern
4. Automatic sprinkler systems that have been maintained in working order.	2010-02-25	2010-03-29	Minimal harm or potential for actual harm	Pattern

Resident Councils

The law requires nursing homes to allow councils to be set up by residents and families. Resident and family councils can facilitate communications with staff. If a nursing home does not have a resident and family council, ask the administrator why. If there is a council, ask to talk with council presidents to get a sense of how the nursing home has acted on their concerns.

Ownership Type

Nursing homes can be run by private for-profit corporations, non-profit corporations, religious affiliated organizations, or government entities. Quality of nursing homes can vary within each of these different types of ownership. Each nursing home needs to be judged on its own merits.

Multiple Nursing Home Ownership

Multi-nursing home chains have two or more homes under one ownership or operation.

Registered Nurse

Registered nurses (RNs) have between 2 and 6 years of education

Licensed Practical and Vocational Nurse

Licensed practical and vocational nurses (LPNs/LVNs) generally have 1 year of training. By law, RNs must assess residents' needs. RNs and LPNs/LVNs work together to plan care, implement care and treatment, and evaluate residents' outcomes. Nurses must be licensed in the state and are on site to provide care to residents twenty-four hours per day, seven days a week.

Certified Nursing Assistant

Certified nursing assistants (CNAs) provide care on a twenty-four hour basis. They work under the direction of a licensed nurse to assist residents with activities of daily living, i.e., eating, grooming, hygiene, dressing, transferring, and toileting. To become a full time certified nursing assistants (CNAs) one must have completed a competency evaluation program or nurse assistant training within 4 months of their permanent employment. They must also pursue continuing education each year.

On Site Services

On site services provide insight into the actual services that the Nursing Home offers. These services include dental service, dietary service, mental health service and others. This information will allow you to see if the Nursing Home provides these services or if they contract with an outside agency for these services.

Percentage of Residents Whose Ability to Move about in and around Their Room Got Worse

This measure indicates the percentage of residents whose ability to move about, either by walking or using a wheelchair, in their room and the hallway near their room, got worse since their last assessment. (Lower percentages are better.)

A decline in physical activity may come with age due to muscle loss, joint stiffness, worsening illness, fear of injury, or depression. Residents who lose mobility may also lose the ability to perform other activities of daily living, like eating, dressing, or getting to the bathroom. In some cases, however, the decline measured may be temporary and due to a short-term illness the resident is experiencing at the time of the assessment.

A lack of movement affects the resident in many ways. It becomes difficult to participate in physical and social activities. Sleep quality can suffer. The risk of heart disease, stroke, diabetes, or blood clots can increase. Depression and anxiety can worsen. Staying in one position and constant pressure on the skin can increase the chance of pressure sores. It is important for residents to be as active as possible.

Nursing home staff can help residents move around more. For instance, they can encourage residents to take part in physical and social activities or take them for regular walks if they need help. Most residents value being able to move about on their own and take care of themselves. It is important that nursing home staff encourage residents to do as much as they can for themselves and stay as active as physically possible. Some residents will decline in their ability to move about, even though the nursing home staff makes a good effort to keep them more active

Percentage of High Risk Residents Who Have Pressure Sores

This measure indicates the percent of residents, among all residents at high risk for getting pressure sores, who get a pressure sore in the nursing home. (Lower percentages are better.) A resident is at high risk for getting pressure sores if he or she is in a coma, doesn't get the nutrients they need (like water, vitamins, and minerals), or can't move or change position on their own.

A pressure sore is a skin wound. Pressure sores are sometimes called bedsores. These sores can be caused by pressure on the skin from chairs, wheelchairs, or beds. Pressure sores usually develop on bony parts of the body such as the tailbone, hip, ankle, or heel. They are usually caused by constant pressure on one part of the skin.

Pressure sores may:

be painful
take a long time to heal
cause other complications such as skin and bone infections

Percentage of Residents Who Spend Most of Their Time in Bed or in a Chair

This measure indicates the percentage of residents who spent most of their time in bed or in a chair in their room during the 7-day assessment period. (Lower percentages are better.)

A decline in physical activity may come with age due to muscle loss, joint stiffness, fear of injury, worsening illness, or depression. Residents who spend too much time in bed or a chair may lose the ability to perform activities of daily living, like eating, dressing, or getting to the bathroom.

Staying in a bed or chair affects the resident in many ways. Unused muscles get weaker. It becomes difficult to participate in physical and social activities. Sleep quality can suffer. The risk of heart disease, stroke, diabetes, or blood clots can increase. Depression and anxiety can worsen. Staying in one position, and constant pressure on the skin can increase the chance of pressure sores. It is important for residents to be as active as possible.

Nursing home staff can help residents be more active. For instance, they can encourage residents to take part in physical activities or take them for regular walks if they need help. Most residents value being able to take care of themselves. It is important that nursing home staff encourage residents to do as much as they can for themselves and stay as active as physically possible. Some residents will choose to remain in bed or in a chair even though the nursing home staff makes a good effort to keep them more active. It is also important to note that some residents may be counted in this measure if their assessment period occurs when they are temporarily ill and are remaining in bed due to a short-term problem.

Percentage of Residents Who Were Physically Restrained

This measure indicates the percent of residents in the nursing home who were physically restrained daily during the 7-day assessment period. (Lower percentages are better.)

A physical restraint is any device, material, or equipment attached or adjacent to a resident's body, which the individual cannot remove easily, that keeps a resident from moving freely or prevents them normal access to their body. Examples of physical restraints include special types of vests, chairs with lap trays, lap belts, and enclosed walkers. Bed rails (side rails) are also considered restraints in certain situations, but they are not used in the calculation of this measure.

Restraints should only be used when they are necessary as part of the treatment of a resident's medical condition. Only a doctor can order a restraint. Restraints should never be used to punish a resident or to make things easier for the staff. Facilities are not allowed to use restraints based solely on a family's request, unless there is a documented medical need and a doctor's order. A resident who is restrained daily can become weak, lose the ability to go to the bathroom by themselves, and develop pressure sores or other medical complications.

Percentage of Residents Whose Need for Help with Daily Activities Has Increased

The daily activities that this measure counts include:

feeding oneself
moving from one chair to another
changing positions while in bed
going to the bathroom alone

Residents are checked routinely to see how they function doing these basic daily activities. Some loss of function may be expected in the elderly. If they are in poor health or if they are ill (for example, if they have pneumonia, an infection, a recent injury, or a chronic problem like asthma that has flared up), they may have a temporary loss of function. Sudden or rapid loss of one or more of these basic daily tasks could mean the resident needs medical attention.

Most residents value being able to take care of themselves. It is important that nursing home staff encourage residents to do as much as they can for themselves. In some cases, it may take more staff time to allow residents to do these tasks than to do the tasks for them. Residents who still do these basic daily activities with little help may feel better about themselves and stay more active. This can affect their health in a good way. When people stop taking care of themselves, it may mean that their health has gotten worse. The resident's ability to perform daily functions is important in maintaining their current health status and quality of life. Some residents will lose function in their basic daily activities even though the nursing home provides good care.

Percentage of Low Risk Residents Who Lose Control of Their Bowels and Bladder

This measure indicates the percent of residents who often lose control of their bowels or bladder. (Lower percentages are better.) This information is only based on residents who have a low risk for losing control of their bowel or bladder. Residents have a low risk for losing bowel and bladder control if they do not have either severe dementia (memory loss) or a very limited ability to move on their own.

Loss of bowel or bladder control is not a normal sign of aging and can often be successfully treated. Loss of bowel and bladder control can be caused by:

physical problems (like constipation, muscle weakness, or a bladder infection)
location problems (like the bathroom being too far away)
reaction to medication
limited ability to walk or move around
diet and fluid intake
toilet routine (timing trips to the bathroom)
whether someone can provide assistance when needed
certain medical conditions, such as diabetes, dementia, spinal cord injury, or neurological disease

Finding the cause and treating a problem with bowel or bladder control is important for many reasons. Physically, it can help prevent infections and pressure sores. Mentally, treatment can help the well being of the resident by restoring dignity and social interaction. Having fewer residents with bowel and bladder control problems can give the nursing home staff more time to provide other care.

Five Star Quality Rating

Much Above Avg. 5 out of 5 stars
Above Avg. 4 out of 5 stars
Average 3 out of 5 stars
Below Avg. 2 out of 5 stars
Much Below Avg. 1 out of 5 stars

Percentage of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder

This measure indicates the percent of residents who had a catheter inserted and left in their bladder for a period of time during the 14-day assessment period. (Lower percentages are better.)

A catheter is a thin, soft tube that is inserted into the bladder and attached to a bag that collects the urine. It may be inserted into the bladder of a patient who has lost control of their bladder or cannot use a toilet (for instance, someone in a coma). Catheters may be used because there is a physical reason the urine cannot drain naturally, to keep a patient with pressure sores that are not healing clean and dry, or to measure the amount of urine being produced.

A catheter should only be used when it is medically necessary. Residents may need a lot of help to get to the toilet, or they may have to go frequently. A catheter should not be used for the convenience of the nursing home staff. Using a catheter may result in complications like urinary tract or blood infections, physical injury, skin problems, bladder stones, or blood in the urine. Some studies have shown that long-term use of indwelling catheters (over many years) may increase the rates of bladder cancer in patients with spinal cord injuries.

Percentage of Residents with a Urinary Tract Infection

This measure indicates the percentage of residents who had an infection in their urinary tract at any time during the 30 days before their most recent assessment. (Lower percentages are better.)

A urinary tract infection (UTI) is an infection in the urethra that, if left untreated, can spread to the bladder (bladder infection) and kidney (kidney infection).

If the area where waste (urine and bowel movements) leaves the body is not kept clean, bacteria from the colon may multiply and enter the urethra (the tube that passes urine from the bladder to outside the body), causing a UTI. A UTI may also be caused by bacteria on a catheter (a soft tube) being used to drain urine from the bladder.

Most urinary tract infections can be prevented by keeping the area clean, emptying the bladder regularly, and drinking enough fluid. Nursing home staff should make sure the resident has good hygiene. Finding the cause and getting early treatment of a UTI can prevent the infection from spreading and becoming more serious or causing complications like delirium. It is important to find out whether the UTI is caused by a physical problem, like an enlarged prostate, so proper medical treatment can be given.

Percentage of Residents Who Are More Depressed or Anxious

This measure indicates the percentage of residents who have become more depressed or anxious in the nursing home since the last time they were checked. (Lower percentages are better.)

Depression is a medical problem of the brain that can affect how a person thinks, feels, and behaves. Signs of depression may include fatigue, a loss of interest in normal activities, poor appetite, and problems with concentration and sleeping.

Anxiety is excessive worry. Signs of anxiety can include trembling, muscle aches, problems sleeping, stomach pain, dizziness, and irritability.

Feeling depressed or anxious can lessen one's quality of life and lead to other health problems. Nursing home residents are at a high risk for developing depression and anxiety for many reasons, such as loss of a spouse, family members, or friends; chronic pain and illness; difficulty adjusting to the nursing home; and frustration with memory loss. Identifying depression and anxiety can be difficult in elderly patients because the signs may be confused with the normal aging process, a side effect of a medication, or the result of a medical condition. Proper treatment may include medication, therapy, or an increase in social support.

Percentage of Residents Who Lose Too Much Weight

This measure indicates the percentage of residents who have lost too much weight. (Lower percentages are better.)

A loss of 5% or more of body weight in one month is usually considered unhealthy (for example, a 150 pound person should not lose more than 7.5 pounds in one month). Too much weight loss can make a person weak, change how medicine works in the body, or cause the skin to break down, which can lead to pressure sores. Too much weight loss may mean that the resident is ill, refuses to eat, is depressed, or has a medical problem that makes eating difficult (like weakness caused by a stroke). It could also mean that the resident is not being fed properly, their medical care is not being properly managed, or that the nursing home's nutrition program is poor. To help prevent unhealthy weight loss, it is important that the resident's diet is balanced and nutritious, and that staff spend enough time feeding people who can't feed themselves. Sometimes it may be necessary for a person to lose weight for medical reasons. In these cases, the medical staff may plan in advance for the resident to lose weight on a special weight loss program, but the person should not lose more than 5% of body weight in one month.

Percentage of Residents Who Have Moderate to Severe Pain

This indicates the percentage of residents who are reported to have moderate to severe pain during the 7-day assessment period. This measure is shown to encourage you to talk to the nursing home staff about how they check and manage pain, and to make you aware of how important it is. Pain can be caused by a variety of medical conditions. Checking for pain and pain management are very complex.

Comparing these percentages is different from the other measures because the percentages may mean different things. Generally, a lower percentage on this measure is better. However, this isn't always true. For example, two nursing homes could provide the same quality of care and have the same number of residents with pain. However, if one of the nursing homes does a better job checking the residents for pain, they could have a higher percentage on this measure. Or, if for personal or cultural reasons, more residents in one of the nursing homes refuse to take pain medication, that nursing home's percentage would be higher. In these examples, although the percentage for one nursing home is higher, it does not mean they are not providing good care.

Residents should always be checked regularly by nursing home staff to see if they are having pain. Residents (or someone on their behalf) should let staff know if they are in pain so efforts can be made to find the cause and make the resident more comfortable. If pain is not treated, a resident may not be able to perform daily routines, may become depressed, or may have an overall poor quality of life. This percentage may include some residents who are getting or have been prescribed treatment for their pain but who refuse pain medicines or choose to take less. Some residents may choose to accept a certain level of pain so they can stay more alert.

Percentage of Long-Stay Residents Who Were Assessed and Given Pneumococcal Vaccination

A pneumococcal vaccination otherwise known as pneumococcal shot may help you prevent, or lower the risk of becoming seriously ill from pneumonia caused by bacteria. It may also help you prevent future infections.

Residents of nursing homes should be asked if they have been vaccinated for pneumonia, and if not, you should be given the pneumococcal shot unless there is a medical reason why you should not receive it.

Percentage of Long-Stay Residents Given Influenza Vaccination During the Flu Season

Influenza is also known as the "flu" and is a contagious form of a respiratory infection. The flu is easily transmitted from person to person. The most common form of spreading this condition is when a person coughs or sneezes.

Receiving an immunization (influenza vaccination or flu shot) can prevent you from getting the flu or at the least help to reduce your risk of becoming seriously ill from the flu. People 65 years of age and older tend to be at a higher risk of becoming seriously ill from the flu. These illnesses can develop into serious and sometime life threatening medical complications. It is recommended that if you are 65 or older you should get a flu shot once a year if no medical condition would preclude you from receiving one.

The flu season is between October and March of each year. Residents of nursing homes should have a flu shot once every year during the flu season. You doctor will explain to you if you have a medical condition or situation that would not allow you to receive a flu shot.

Overall Rating

The overall rating is a combination of the health inspection rating, the staffing rating, and the quality measures rating. Analysis was conducted on these three data sources and each of these ratings were combined into one overall rating.

When looking at the five-star ratings, more stars are better. Five (5) stars are the most a nursing home can get. One (1) star is the fewest.

Health Inspection Result Rating

Strengths:

Comprehensive: The nursing home health inspection process looks at all major aspects of care in a nursing home (about 180 different items).
Onsite Visits by Trained Inspectors: It is the only source of information that comes from a trained team of objective surveyors who visit each nursing home to check on the quality of care, inspect medical records, and talk with residents about their care.
Federal Quality Checks: Federal surveyors check on the state surveyors' work to make sure they are following the national process and that any differences between states stay within reasonable bounds.

Limits:

Variation between States: There are some differences in how different states carry out the inspection process, even though the standards are the same across the country.
Medicaid Program Differences: There are also differences in state licensing requirements that affect quality, and in state Medicaid programs that pay for much of the care in nursing homes

Staffing Rating

Strengths:

Overall Staffing: The quality ratings look at the overall number of staff compared to the number of residents and how many of the staff are trained nurses.
Adjusted for the Population: The ratings consider differences in how sick the nursing home residents are in each nursing home, since that will make a difference in how many staff are needed.

Limits:

Self-Reported: The staffing data are self-reported by the nursing home, rather than collected and reported by an independent agency.
Snap-Shot in Time: Staffing data are reported just once a year and reflect staffing over a 2 week period of time.

Quality Measures Rating

Strengths:

In-Depth Look: The quality measures provide an important in-depth look at how well each nursing home performs on ten important aspects of care. For example, these measures show how well the nursing home helps people keep their ability to dress and eat, or how well the nursing home prevents and treats skin ulcers.
National Measures: The ten quality measures we use in the Five-Star rating are used in all nursing homes.

Limits:

Self-Reported Data: The quality measures are self-reported by the nursing home, rather than collected and reported by an independent agency.
Just a Few Aspects of Care: The quality measures represent only a few of the many aspects of care that may be important to you.

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Other Cost Report Years:

Fiscal Year Begin: 2011-01-01 | Fiscal Year End: 2011-06-06

Nutrition and Dietary Deficiencies

Pharmacy Service Deficiencies

Environmental Deficiencies

Administration Deficiencies

Resident Rights Deficiencies

Quality Care Deficiencies

Resident Assessment Deficiencies

Corridor Walls and Doors Deficiencies

Smoke Compartmentation and Control Deficiencies

Electrical Deficiencies

Furnishings and Decorations Deficiencies

Illumination and Emergency Power Deficiencies

Fire Alarm Systems Deficiencies

Smoking Regulations Deficiencies

Vertical Openings Deficiencies

Medical Gases and Anesthetizing Areas Deficiencies

Building Construction Deficiencies

Hazardous Area Deficiencies

Automatic Sprinkler Systems Deficiencies

Resident Councils

Ownership Type

Multiple Nursing Home Ownership

Registered Nurse

Licensed Practical and Vocational Nurse

Certified Nursing Assistant

On Site Services

Percentage of Residents Whose Ability to Move about in and around Their Room Got Worse

Percentage of High Risk Residents Who Have Pressure Sores

Percentage of Residents Who Spend Most of Their Time in Bed or in a Chair

Percentage of Residents Who Were Physically Restrained

Percentage of Residents Whose Need for Help with Daily Activities Has Increased

Percentage of Low Risk Residents Who Lose Control of Their Bowels and Bladder

Five Star Quality Rating

Percentage of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder

Percentage of Residents with a Urinary Tract Infection